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Just diagnosed but headed back for 2nd study. Advice?
#11
Just a follow up after speaking with them...

They ended on a high pressure of 16 and 20 on bipap. I was only at that pressure for 15 minutes before the study was concluded. They want to see if I'm going to need a pressure over 20 or not.

Here is my question: even if 20 works for me, since it is borderline bipap, would I just be better off getting a dreamstation bipap anyways? If for whatever reason my pressure needs to go up I'd be up the creek with a cpap\apap.

Unfortunately it sounds like I'm going to have to return the dreamstation auto and wait a few weeks.
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#12
Piggles, if you have any SleepyHead data you can post (see my signature for help), we can perhaps advise you. Something else to consider is that in some people the high numbers of obstructive apnea that don't respond to reasonable pressure comes from a sleeping position where you tuck your chin towards the chest and occlude the trachea. This can be prevented with an inexpensive soft cervical collar from Walgreens, Walmart, Rite Aide, etc. Your Dreamstation Auto will provide feedback on how effective your therapy is.

If you have the Dreamstation, use it. Set the minimum pressure at 12 and maximum at 20 and find out what works.
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#13
(12-28-2016, 11:26 AM)Piggles Wrote: Just a follow up after speaking with them...

They ended on a high pressure of 16 and 20 on bipap. I was only at that pressure for 15 minutes before the study was concluded. They want to see if I'm going to need a pressure over 20 or not.

Here is my question: even if 20 works for me, since it is borderline bipap, would I just be better off getting a dreamstation bipap anyways? If for whatever reason my pressure needs to go up I'd be up the creek with a cpap\apap.

Unfortunately it sounds like I'm going to have to return the dreamstation auto and wait a few weeks.


That is where I was. I was 18-20 CPAP and throwing 12 AHI, (with LARGE LEAKS/Mouth Breathing I was unaware of) My Dr. agreed with me and I now have a ResMed Aircurve VAuto BiPAP machine.
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#14
(12-28-2016, 11:33 AM)Sleeprider Wrote: Piggles, if you have any data you can post (see my signature for help), we can perhaps advise you. Something else to consider is that in some people the high numbers of obstructive apnea that don't respond to reasonable pressure comes from a sleeping position where you tuck your chin towards the chest and occlude the trachea. This can be prevented with an inexpensive soft cervical collar from Walgreens, Walmart, Rite Aide, etc. Your Dreamstation Auto will provide feedback on how effective your therapy is.

If you have the Dreamstation, use it. Set the minimum pressure at 12 and maximum at 20 and find out what works.

Understood. I'm also not a back sleeper which is how they do the study for worst case.

The dreamstation auto arrives today. I found a price I couldn't pass up so bought it a bit prematurly. Unfortunately opening it would be an expensive gamble since I wouldn't be able to return it. I'm going to have to do the 2nd study tomorrow and hope I end up on a lower pressure.

Is it fairly safe to assume the pressure I wake up to at the end of the study is the pressure they decided was "optimal"?
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#15
When you go to the sleep study, alert the technican to note whether you tend to tuck your chin. This results in very high AHI and pressure requirements, even when on your side. It is possible in some cases to resolve OSA with lower pressures, if that posture is avoided. So be sure to get the data on that point of concern. You can even try a soft collar before the study and see if it seems to help. Try this; sitting in a chair, let your head tip forward so your chin rests on your chest. Note the difference in breathing effort?
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#16
(12-28-2016, 12:12 PM)Sleeprider Wrote: When you go to the sleep study, alert the technican to note whether you tend to tuck your chin. This results in very high AHI and pressure requirements, even when on your side. It is possible in some cases to resolve OSA with lower pressures, if that posture is avoided. So be sure to get the data on that point of concern. You can even try a soft collar before the study and see if it seems to help. Try this; sitting in a chair, let your head tip forward so your chin rests on your chest. Note the difference in breathing effort?

(According to the wife) When I am on my back I tend to sleep with my head sideways and cocked up, instead of down. She says it looks very uncomfortable but I guess it was probably just my body's way of opening up the air passage.

I typically use a pretty firm memory foam pillow and I took it with me on the first sleep study. Would it be advised that I use a softer pillow that will allow my head to settle back for the second study?

Dreamstation Auto just arrived. Therapy is so close but so far away! Sad
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#17
The advantage of your current course is that even if you are titrated with a high pressure of 18-20 a bilevel may be in order to give you exhale relief and more versatility in case your pressure needs increase in the future. You should ask if bilevel will be tried during your study, with the objective of helping you remain asleep when pressure is high.

The only disadvantage is if you have poor insurance with high deductibles and copays. You will incur more costs for the sleep study, and a higher cost machine.

I assume you got the Dreamstation for under $400. You already said you disliked the changes in pressure from your titration study. You seem to have some sensitivity to costs. Based on that, I would open the machine (got a mask?) and use it and record the data. Your worst case is that you may lose up to $100 in value selling it lightly used. If it works, you can cancel the next study and save much more than that. Based on your previous results, you will need a relatively high minimum pressure (14?) and let the machine adjust to 20. I see this as an exercise in financial risk exposure. You will know shortly if it works.
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#18
(12-28-2016, 02:07 PM)Sleeprider Wrote: The advantage of your current course is that even if you are titrated with a high pressure of 18-20 a bilevel may be in order to give you exhale relief and more versatility in case your pressure needs increase in the future. You should ask if bilevel will be tried during your study, with the objective of helping you remain asleep when pressure is high.

The only disadvantage is if you have poor insurance with high deductibles and copays. You will incur more costs for the sleep study, and a higher cost machine.

I assume you got the Dreamstation for under $400. You already said you disliked the changes in pressure from your titration study. You seem to have some sensitivity to costs. Based on that, I would open the machine (got a mask?) and use it and record the data. Your worst case is that you may lose up to $100 in value selling it lightly used. If it works, you can cancel the next study and save much more than that. Based on your previous results, you will need a relatively high minimum pressure (14?) and let the machine adjust to 20. I see this as an exercise in financial risk exposure. You will know shortly if it works.

My second study is tomorrow night so I'm going to try to not sleep much tonight. I have no interest in a third study so I want to make sure I remain asleep for them as long as possible. I don't expect to have a chance to really use the Dreamstation Auto before tomorrow's titration so I'll just hope that I land below 20 but that isn't looking all that likely.

I do have chronic sinus problems with constant drainage, congestion, etc. so I'm sure that requires a bit more pressure to break through as well.

Thanks again for everyone's responses.
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#19
Good luck! Looks like things are happening pretty quickly, so I agree.

I think I must have been exposed to small children over christmas. I ended up with congestion, cough and a 100 degree fever last night, and it's continuing today. So I can relate to the congestion. The only time I don't mouth-breath with this, is at night using nasal pillows.
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#20
My second study / titration is complete. When I woke up in the morning and looked at the pressure on the machine it was just above 20. So it sounds like the safest bet is now to return the Dreamstation auto.

Question: If I were to get a Dreamstation bipap auto, it is capable of doing everything the Dreamstation auto can do + more, is that correct? The only downside is cost?
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